Meredith Nettles D'Agostino, DNP, PMHNP, CPNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

816203 Issued in NV

Practice address

500 N Rainbow Blvd Ste 300-345
Las Vegas, NV 89107-1082

Phone

(833) 246-8353

Fax

(844) 750-6902

NPI assigned

Jun 9, 2008

Last updated

Sep 8, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other identifiers 3

Electronic endpoints 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Pediatric Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/32843/brand/2/csg/1/fhir/r4
• Direct secure messaging: meredith.d.agostino.1@32843.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Shorelines

  • Psychiatric/Mental Health Nurse Practitioner
  • Las Vegas, NV
  • NPI 1225675861
  NPD Authorized official
• Thrive Wellness of Reno LLC

  • Clinical Social Worker
  • Reno, NV
  • NPI 1629565908
  NPD (past)
• University Pediatrics

  • Pediatrics Physician
  • Columbia, SC
  • NPI 1083657233
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1212969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599523200000",
    "number": "1871752303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 N RAINBOW BLVD STE 300-345",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891071082",
            "telephone_number": "833-246-8353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N RAINBOW BLVD STE 300-345",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891071082",
            "telephone_number": "833-246-8353",
            "fax_number": "844-750-6902"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "927 Legends Club Dr",
            "address_purpose": "LOCATION",
            "city": "Mount Pleasant",
            "state": "SC",
            "postal_code": "294669055",
            "country_code": "US",
            "telephone_number": "833-246-8353 x700",
            "fax_number": "844-750-6902",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "216 Scott St",
            "address_purpose": "LOCATION",
            "city": "Mount Pleasant",
            "state": "SC",
            "postal_code": "294644345",
            "country_code": "US",
            "telephone_number": "843-619-3571",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "D'AGOSTINO",
        "first_name": "MEREDITH",
        "middle_name": "NETTLES",
        "credential": "DNP, PMHNP, CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-09",
        "last_updated": "2020-09-08",
        "certification_date": "2020-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "SC",
            "license": "3584",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "SC",
            "license": "3584",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NV",
            "license": "816203",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP1367",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "3584-APRN",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NV APRN LICENSE",
            "identifier": "816203",
            "state": "NV"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "meredith@shorelinescare.com",
            "affiliation": "N",
            "address_1": "927 Legends Club Dr",
            "city": "MT Pleasant",
            "state": "SC",
            "country_code": "US",
            "postal_code": "294669055",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "meredith@shorelinescare.com",
            "affiliation": "N",
            "address_1": "216 Scott St",
            "city": "Mount Pleasant",
            "state": "SC",
            "country_code": "US",
            "postal_code": "294644345",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "meredith@shorelinescare.com",
            "affiliation": "N",
            "address_1": "500 N Rainbow Blvd Ste 300-345",
            "city": "Las Vegas",
            "state": "NV",
            "country_code": "US",
            "postal_code": "891071082",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Psychiatric/Mental Health Nurse Practitioner in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Psychiatric/Mental Health Nurse Practitioner in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.